Continuing Education & Resources for Mental Health Professionals

Ethical Decision-Making Model*

Mary Alice Fisher, Ph.D., 2005
The Center for Ethical Practice, Inc.

I. ASSESS

A. Identify the problem and determine whether the matter is an ethical one. Use your Ethics Code and other professional guidelines to identify the specific ethical issues.

B. If this involves a clinical issue, describe and clarify the relevant clinical components.

C. Consider whether there are any legal requirements, contractual obligations or agency considerations that might influence your decision or limit your options.

D. Consider, as clearly as possible, any relevant personal values (or other personal factors) that might affect your objectivity, introduce bias, or otherwise influence your decision.

E. Evaluate the rights, vulnerabilities, and responsibilities of all parties involved. Determine your relationship (if any) and obligations (if any) to each of these parties.

F. Obtain consultation. Consult with a trusted colleague or supervisor about the ethical, legal and personal issues involved. If needed, obtain a formal consultation with an ethics consultant or with the ethics office of your professional association. If necessary obtain legal consultation and/or medical consultation.

G. Consider whether members of your team or practice group should be engaging in this decision-making process with you. If so, begin discussing the issue collaboratively.

II. PLAN

A. Generate a list of possible decisions/solutions. (At this stage, do not censor; consider all possible courses of action, no matter how wild/crazy/inappropriate they seem.)

B. Using this list, eliminate any options that are clearly unethical, illegal, or clinically inappropriate, using the assessment above as a guide.

C. Enumerate, consider, and weigh the consequences of each of the remaining options.

III. IMPLEMENT

A. Make a decision. Decide how to best act on (carry out) your decision..

B. Carry out the decision you have made.

IV. EVALUATE

A. Document your decision-making process and your actions.

B. Evaluate the process, your decision, and its outcome.

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*This Ethical Decision-Making Model was constructed using principles that are included in existing decision-making models from several mental health professions, including the following:

Forester-Miller, H., & Davis, T. (1996). A Practitioner’s Guide to Ethical Decision Making.  American Counseling Association.

Knapp, S. & VandeCreek, L. (2006). Practical ethics for psychologists: A positive approach. Washington D.C., American Psychological Association.

Koocher, G.P. & Keith-Spiegel, P. (2008) Ethics in Psychology: Professional Standards and Cases. New York, Oxford U. Press.

Mattison, M. (2000) Ethical Decision Making: The Person in the Process. Social Work, 45 , 201.

Pope, K. S., & Vasquez, M. J. T. (2007). Ethics in psychotherapy and counseling: A practical guide (3rd ed.). San Francisco: Jossey Bass.

Reigle, J. (1996) Ethical Decision-Making Skills. In: Hamric, A.B., Spross, J.A. & Hanson, C.M. (Eds) Advanced Nursing Practice: An Integrative Approach. Philadelphia, W. B. Saunders Company.

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